Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or New York for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to New York only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. New York (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Planned Parenthood Of Central And Western New York, Inc (NPI 1306909957)

Planned Parenthood Of Central And Western New York, Inc is a ambulatory family planning facility provider located in Rochester, New York. This profile covers 0 Medicare and 59 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Planned Parenthood Of Central And Western New York, Inc
Address	114 University Ave
City	Rochester
State	NY
ZIP	14605
Taxonomy	Ambulatory Family Planning Facility
NPI Enumerated	December 18, 2006

Payer Source	Total Paid
Medicaid	$20.8M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

59 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	35,570	$100	$3.6M
59840	In this procedure, the provider deliberately terminates a pregnancy for elective or therapeutic reasons. He removes the fetus and products of conception by dilating the cervix and then using a…	4,900	$600	$2.9M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	26,940	$100	$2.8M
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	16,510	$100	$1.7M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	27,960	$30	$838.6K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	8,640	$90	$742.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	5,720	$130	$720.6K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	4,800	$150	$704.9K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	1,550	$450	$701.5K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	4,720	$140	$665.5K

Showing 1–10 of 59

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.

Claims Volume vs. New York Distribution

Planned Parenthood Of Central And Western New York, Inc — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. New York median

59 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
59840	In this procedure, the provider deliberately terminates a pregnancy for elective or therapeutic reasons. He removes the fetus and products of conception by dilating the cervix and then using a…	4	30	370	$510	$1.2M
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	3	30	110	$620	$410.7K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	400	19,110	360	$70	$321K
11982	The provider removes a non–biodegradable implant (a capsule or pellet with controlled–release properties containing a drug for long term delivery).	2	10	230	$300	$274.1K
J7300	Intrauterine copper contraceptive (paragard)	8	20	40	$560	$224.4K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	24	410	1,190	$20	$209.8K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	23	370	1,530	$20	$192.3K
J7297	Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg	2	10	80	$340	$189.6K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	183	16,550	220	$90	$186.8K
11981	The provider inserts a bioresorbable, biodegradable, or non–biodegradable implant, such as a capsule or pellet, containing a drug for long–term delivery.	2	20	70	$270	$183.3K

Showing 1–10 of 59

Planned Parenthood Of Central And Western New York, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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